Resuscitator apparatus



Aug. 22, 1967 I E p THOMAS 3,336,920

RESUSCITATOR APPARATUS Filed June 135, 1964 2 Sheets-Sheet 1 to: L111 72:1 I if? I A53 E11; 45 F 3Q l v I I I 43*?- 52 r INVENTOR Eugene P. Thomas Aug. 22, 1967 E. P. THOMAS 3,336,920

RESUSCITATOR APPARATUS Filed June 25, 1964 2 Sheets-Sheet 2 Fig.

United States Patent 3,336,920 RESUSCITATOR APPARATUS Eugene P. Thomas, Baltimore, Md., assignor to Westinghouse Electric Corporation, East Pittsburgh, Pa., a corporation of Pennsylvania Filed June 25, 1964, Ser. No. 377,853 7 Claims. (Cl. 128-53) The present invention relates to resuscitator apparatus, and more particularly to pneumatic resuscitator apparatus for ventilation of a victims lungs which is adapted for use in conjunction with heart resuscitation as effected by a pneumatically-operated chest-compressing cylinder device.

In cardiac arrest, both heart beat and breathing are suspended. The heart can be caused to pump artificially by operation of a pneumatic-cylinder-operated plunger to exert rhythmic downward force on the breastbone of a heart arrest victim to alternately compress and release the victims heart and thereby cause it to pump blood. Such a cylinder-operated plunger for closed-chest heart resuscitation together with pneumatic controls therefor is exemplified in my copending patent application, Ser. No. 274,092, filed Apr. 19, 1963 now US. Patent No. 3,209,748 and assigned to the assignee of the present application. Such exemplified cylinder apparatus is adaptedfor operation from a source of compressed gas, such as an oxygen bottle.

Since it is also necessary to artificially respirate a heart arrest victim, it becomes a prime object of the present invention to provide improved apparatus for so doing in conjunction with use of a pneumatically-operated chestcompressing heart resuscitator.

It is another object of the present invention to provide a lung resuscitator apparatus which utilizes the pneumatic exhaust from a chest-compressor cylinder of a heart resuscitator.

It is another object of the present invention to provide a combined lung and heart resuscitator apparatus operated from a bottled oxygen source which minimizes use of such oxygen.

It is yet another object of the present invention to provide a lung resuscitator apparatus for use in conjunction with a pneumatic chest-compressor cylinder which may be employed successfully with minimal experience and maximum safety.

In general, one exemplification of the present invention employs pressure-regulated accumulator means to store pulses of exhaust air or oxygen from the chest-compressing cylinder of a heart resuscitator, together with a manuallyoperable valve means to control admission of such air or oxygen from the accumulator means to the victim via the usual face mask covering the victims mouth and nose. Other exemplified extensions and variants of the present invention as set forth herein, relate to an alternate version of the accumulator means; an arrangement for automating admission of the stored air or oxygen pulses to the victims lungs, and arrangements for adding atmospheric air and/ or oxygen from a bottled source to the chest-compressorcylinder exhaust for supply to the victims lungs.

Other features, objects, and advantages of the invention will become apparent from the following detailed description, when taken in connection with the accompanying drawings, in which:

FIGURE 1 is a schematic representation in simplified form, partly in section and partly in outline, of the novel resuscitator apparatus in aifiliation with a chest-compressor cylinder;

' FIG. 2 is an alternate pressure-regulating and exhaust pulse accumulator means such as may be employed in the apparatus of FIG. 1 in lieu of the simplified form shown therein;

FIG. 3 is a schematic representation of an illustrative resuscitator apparatus as embodying means for automatically regulating supply of stored chestcompressorcylinder exhaust air or oxygen to the victims lungs;

FIG. 4 is a schematic representation, predominately in cross section, of a pneumatic-pulse-counter timing valve means employed in the apparatus of FIG. 3; and

FIG. 5 is a schematic representation in outline, showing a resuscitator system including an arrangement for supply of oxygen to the victims lungs in addition to that available from exhaust from a heart resuscitator chest-compressing cylinder.

Referring to FIG. 1, the invention is affiliated with a chest compressor cylinder 2 which is shown, together with its control valve device 1, both as described in the aforementioned copending patent application, Ser. No. 274,092, and each bears the same reference numerals used therein. Briefly, compressed air or oxygen is alternately supplied to the chest compressing cylinder 2 by pulsed operation of the valve device 1 to cause the plunger pad 33 to compress and release a heart victi'ms chest. The supply is available from such as an oxygen bottle (not shown) via a fluid pressure supply conduit means 21, the chamber 18 in valve device 1, and a communication 22 to the chamber 31 atop piston 30 in the cylinder 2 to cause such piston to actuate plunger pad 33 downwardly. Alternately, release of oxygen or air from the top of piston 30 occurs by way of the communication 22, chamber 18 and vent port 24 in valve device 1 while its valve 26 is held in an upper position by spring 19 upon venting of its chamber 16. Since the cylinder 2 is operated reciprocably by such alternate supply and release of air or oxygen thereto, at a rate of sixty shoves per minute, for example, it will be seen that the exhaust of air or oxygen from the cylinder will be in form of short, intermittent pulses. Also, since the piston stroke is not very great, the volume of any individual exhaust pulse is less than the average lung inhalation, which may be of the order of three hundred cubic centimeters, whereas such exhaust pulse at slightly above atmospheric pressure will be perhaps about one hundred cubic centimeters.

In accord with features of the invention, during operation of chest-compressing cylinder 2 the exhaust pulses of air, or oxygen, according to the compressed gaseous fluid medium used for operation of the cylinder 2, is fed from the exhaust port 24 of the cylinder control valve device 1, to a combined accumulator and pressure regulator 40 which includes a cylindrical enclosure 41 and an abutment 4-2 movable by exhaust pulse admission to a chamber 43 against a light bias spring 44 until a release port 45 is uncovered at a time when piston 42 assumes the position indicated in phantom outline 46. At this time, chamber 43 has expanded to store a number of chest-compressorcylinder exhaust pulses, two, three, four, for example, at a low gauge pressure of one-half pound per square inch, for example; a volume and pressure sufficient and safe for causing inflation of the victims lungs. After such exhaust pulse storage within chamber 43, a manually-operable valve device may be actuated by depression of a stem 48 to cause a valve 49 to open the chamber 43 to a face mask 50 over the victims mouth or/ and nose, while such valve also closes a vent port 51 normally open to such face mask. The accumulated cylinder exhaust air or oxygen, under influence of bias spring 44 will be displaced from chamber 43 by downward movement of piston 42 and will flow into the victi-ms lungs by way of communication 24, to fill same with such air or oxygen. At this time, the piston 42 may have assumed its bottom position as indicated by the phantom outline 52. After this, the op rator will release pressure on plunger 48 to allow the 'alve 49 to be reseated upwardly by a compression spring 53 and thereby open the vent port 51 to permit the vicims lungs to deflate via the face mask 50 and such port. 3y periodic manual operation of the valve device 47, inlation and deflation of the victims lungs with chest- :ompressor cylinder exhaust air or oxygen can thus be :ffected and controlled as desired. It will be noted, how- :ver, that should the valve 49 be held depressed even for an undue length of time, no damaging pressure can be 311111: up in the victims lungs, since exhaust pulses from :he cylinder 2 will act to displace the piston 42 upwardly against the light spring 44 until vent port 45 is uncovered.

Also, it is doubtful that face mask 50, which usually Will be of resilient material, can be held so secure on the victims face that leakage therepast would not dissipate undue lung pressure.

Referring now to FIG. 2, a more refined accumulatorpressure regulator device 55 is shown, which in the system of FIG. 1, would replace the device 40 as to function. Wherein the parts are functionally identical, they bear the same reference numerals and their description is not repeated. In the FIG. 2. version, the piston 42 is replaced by a bellows-type long-travel diaphragm 56 of resilient material clamped at its open-mouth annular end 57 between enclosure portions 40a and 40b to permit expansion of chamber 43 against the light bias spring 44. The vent port means 45, however, is located in a fold of the diaphragm and becomes uncovered upon arrival at the desired degree of chamber 43 expansion. This bellows-diaphragm arrangement gives friction-free expansion as against the sliding-piston-type movement of FIG. 1. To control the diaphragm expansion, it has an annular flange or piston portion 59 which is clamped between annular diaphragm follower members 60 and 61, one of which acts as a seat for one end of the spring 44, and both of which act to couple thrust forces between spring and diaphragm. The follower member 60 is in turn secured to one end of a central sleeve member 64 which is slida-bly guided by washer member 65 and 66 on a guide rod 67 extending coaxially within the cylindrical enclosure from one end to the other. This prevents cocking of the diaphragm. To prevent uncontrollable escape of air or oxygen from the chamber 43 via a central opening 68 in the piston portion 59, through which guide rod 67 extends, a resilient annular seal 70 is fit inside sleeve member 64, seated against washer member 66, and in slidable sealing cooperation with the outer surface of such guide rod 67. While the air or oxygen stored in chamber 43 is used for inflation of the victims lungs, the bellows diaphragm 56 will fold around a cylindrical portion 72 of the follower member 60. Initial movement in that direction will cause the vent ports 45 in such diphragm to be closed by the outer surface of follower portion 72 tuitil the assemblage again returns to such chamber-filled postion with vent ports 45 again becoming open, whereupon further increase in pressure in chamber 43 ceases, the diaphragm becomes fully extended, and the assemblage is at rest.

Referring now to FIGS. 3 and 4, the resuscitator apparatus embodies a combined accumulator and pump device 75 which comprises a longtravel bellows diaphragm 76 with its central piston portion clamped to a follower assemblage 77 urged by a compression spring 78 in a direction for expansion of accumulator storage chamber 43. Spring 78 assists the exhaust pressure from the chest compressor cylinder arriving from fluid pressure communication 24 and causes a suction in chamber 43 and in an atmospheric air inlet communication 80 which includes a check valve 81 and needle valve 82 for allowing a regulated amount of atmospheric air to be drawn into chamber 43 for mixture with such as the oxygen exhaust from the chest compressor cylinder. This enables the rate of filling of chamber 43 with a suitable lung supply media to be adjusted independently of the rate of discharge from the chest compressor cylinder.

As in the previous arrangements of FIGS. 1 and 2, expansion of chamber 43 ceases during filling, when a restricted vent of such chamber becomes established. In the present arrangement this is established by unseating of a vent valve 84 which occurs as a result of movement of the diaphragm follower 77 which contains the seat for such valve. The valve 84 is held against chamber-expansion movement of the follower 77 (leftward as viewed in the drawing) by a stem 83 which includes an annular shoulder 84a and which shoulder abuts the end of a lung inflation pumping cylinder 85. A bias compression spring 86 encircling the stem 83 is interposed between another shoulder 87 and the follower 77 which tends to actuate such follower and the piston portion of the diaphragm toward chamber 43 against the action of spring 78. Pumping cylinder includes a piston 89 attached to the valve-opposite end of the stem 83. When supply pressure from a regulator valve 90 is admitted to a piston chamber 91, the piston 89 operates to drive the stem 83 and valve 84 toward chamber 43. Through the medium of its shoulder 87 and the spring 86, the follower member 77 and piston portion of the diaphraghm 76 is caused to move against the spring 78 and displace the air and oxygen stored in chamber 43 into the victims lungs by way of a spring-biased shuttle valve 93 and face mask 94. A compression bias spring 95, acting on shuttle valve 93 against access of mask 94 to chamber 43 and in favor of venting mask 94 to a vent port 96, is of such value relative to that of spring 86, that only the required slight gauge pressure, one-half p.s.i. for example, can be admitted to mask 94. Any excess above this will cause the valve 84 to unseat to vent excess pressure in chamber 43 to the atmosphere. Upon release of pressure from chamber 91, chamber 43 will again re-expand as spring 95 shifts shuttle valve 93 to open the vent port 96 to permit deflation of the victims lungs.

As a further feature of the FIG. 3 arrangement, a pulse-counting valve device 100' is employed to automate pressurization and de-pressurization of lung inflation pump piston chamber 91 and thereby automate inflation and deflation of the victims lungs. This is accomplished by an arrangement which counts a prescribed number of strokes made by the chest compressor cylinder 2 (FIG. 1) and operates a valve to connect chamber 91 to regulator valve 90 via a regulator output conduit 90a, which in turn is available of bottled air or oxygen from the same source 3s that used for operation of the heart compressor cylin- Referring to FIG. 4, device 100 can be made to count the chest compressor cylinder strokes by responding to pressure pulses admitted to a fluid pressure control conduit 101 (FIG. 1) to which the chest cylinder control valve device 1 responds. Each time a positive cylinderoperating pulse appears in line 101, a piston 102 operates a pawl 103 to give a valve-actuating earn 104 a partial turn via an attached ratchet wheel 105 operated by such pawl. Once the required number of cylinder strokes occurs, a high part 106 of the cam actuates a slide valve 107 against a spring 108 via a stem 109 to establish selective connection, via a valve passage 110, between regulator valve 90' and the lung-inflation pump chamber 91. The valve 107 will remain in such position long enough for the victims lungs to become inflated, after which the low part of the cam 104 is presented to stem 109 to permit spring 108 to move the valve 107 to its lower position for connecting chamber 91 to the cylinder exhaust communication 24. The cam will remain so positioned for the required number of cylinder strokes while lung supply chamber 43 again refills, whereupon the procedure automatically repeats.

With any of the preceding arrangements, it is possible to synchronize admission of lung inflation air to the victim according to the stroke of the chest compressor cyl- 11251161, such as during an upstroke, should this be desira e.

In FIG. 5, there is shown a lung ventilation system which utilizes no accumuator for the exhaust pulses in exhaust communication 24 from the chest-compressor cylinder 2 of a portable cardiac resuscitator apparatus 114, but rather provides for suflicient volume of oxygen to the face mask 50 for lung ventilation by makeup from the bottle oxygen source 115 which supplies apparatus 114. This is accomplished by way of a supply line 116 from source 115, a regulator valve device 117 which limits delivery to the inflation control valve 47 via a fluid pressure delivery conduit 118 to a safe value of such as one-half p.s.i. By way of an arrangement of check valves 119 and 120 connected to a common delivery line 121 to the valve device 47, admission to the victims lungs via valve device 47 and face mask 50 will occur from exhaust communication 24 and/or from the conduit 1187 While there have been shown and described illustrative embodiments of the invention, modifications thereto may readily occur to those skilled in the art. It is not desired, therefore, that the invention necessarily be limited to the specific arrangements shown and described and it is intended to cover in the appended claims all such modifications as fall within the true spirit and scope of the invention.

I claim as my invention:

1. In a heat resuscitation apparatus including a chest compressor cylinder having a piston means for alternate compression and release of a heart victims chest, means for intermittently supplying and releasing pulses of compressed gas suitable for life-supporting breathing to and from said cylinder for operating such piston means, the combination therewith of accumulator means for storing such pulsed quantities of gas released from said cylinder, valve means operable to effect supply of such stored gas from said accumulator means to a heart arrest victims lungs, and pressure-regulating means for limiting the pressure of such gas as so supplied to the victim.

2. Resuscitation apparatus as set forth in claim 1, wherein said accumulator means is so constructed and arranged as to constitute also said pressure-regulating means.

3. Resuscitation apparatus as set forth in claim 2, wherein such combined accumulator and pressure-regulator means comprises a rigid enclosure having a movable abutment disposed therein to provide expandability of an expansion chamber for storage of such pulsed quantities of gas, such movable abutment being subject to a light pressure-defining bias against its chamber-expanding movement and operable to establish a pressure relief vent upon movement to a position commensurate with attainment of the desired volume of stored gas within the expansion chamber.

4. Resuscitation apparatus as set forth in claim 1, wherein said accumulator means is constructed and arranged to cause suction of atmospheric air thereinto concurrently with receipt of pulsed quantities of gas from the chest-compressor cylinder discharge.

5. In a combined heart and lung resuscitation apparatus including a chest-compressor cylinder having a piston means for alternate compression and release of a heart victims chest, means for effecting in successive stroke cycles of such piston means by alternate admission of compressed oxygen to said cylinder and release of such oxygen therefrom, the combination therewith of accumulator means for storing oxygen released from said cylinder and control means for automatically eifecting periodic discharge of oxygen from said accumulator means to a victims lungs.

6. Resuscitator apparatus as set forth in claim 5, wherein such periodic discharge from said control means is a function of numbers of strokes made by said piston means.

7. In a combined heart and lung resuscitator apparatus including a fluid-pressure-controlled chest-compressor cylinder having piston means which is operated in successive strokes by periodic supply of oxygen thereto and release therefrom in accord with corresponding control pulses of pressurized oxygen, the combination therewith of accumulator means for storing quantities of oxygen successively released from said cylinder, and means including pulsecounter means responsive to numbers of said control pulses to automatically periodically release oxygen from said accumulator means to a victims lungs.

References Cited UNITED STATES PATENTS 6/1966 Rand et al '12852 3/1967 Henson l28-l45.8 RICHARD A. GAUDET, Primary Examiner. CHARLES F. ROSENBAUM, Examiner. 

1. IN A HEAT RESUSCITATION APPARATUS INCLUDING A CHEST COMPRESSOR CYLINDER HAVING A PISTON MEANS FOR ALTERNATE COMPRESSION AND RELEASE OF A HEART VICTIM''S CHEST, MEANS FOR INTERMITTENTLY SUPPLYING AND RELEASING PULSES OF COMPRESSED GAS SUITABLE FOR LIFE-SUPPORTING BREATHING TO AND FROM SAID CYLINDER FOR OPERATING SUCH PISTON MEANS, THE COMBINATION THEREWITH OF ACCUMULATOR MEANS FOR STORING SUCH PULSED QUANTITIES OF GAS RELEASED FROM SAID CYLINDER, VALVE MEANS OPERABLE TO EFFECT SUPPLY OF SUCH STORED GAS FROM SAID ACCUMULATOR MEANS TO A HEART ARREST VICTIM''S LUNGS, AND PRESSURE-REGULATING MEANS FOR LIMITING THE PRESSURE OF SUCH GAS AS TO SUPPLIED TO THE VICTIM. 